Comparison of efficacy and complications of endoscopic and percutaneous biliary drainage in malignant obstructive jaundice: a systematic review and meta-analysis
Abstract Background Malignant obstructive jaundice is a common problem in the clinic. Currently, the generally applied treatment methods are percutaneous transhepatic biliary drainage (PTBD) and endoscopic biliary drainage (EBD). Nevertheless, there has not been a uniform conclusion published on eit...
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| Format: | Article |
| Language: | English |
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BMC
2017-10-01
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| Series: | Cancer Imaging |
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| Online Access: | http://link.springer.com/article/10.1186/s40644-017-0129-1 |
| _version_ | 1819179516761735168 |
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| author | Feng Duan Li Cui Yanhua Bai Xiaohui Li Jieyu Yan Xuan Liu |
| author_facet | Feng Duan Li Cui Yanhua Bai Xiaohui Li Jieyu Yan Xuan Liu |
| author_sort | Feng Duan |
| collection | DOAJ |
| description | Abstract Background Malignant obstructive jaundice is a common problem in the clinic. Currently, the generally applied treatment methods are percutaneous transhepatic biliary drainage (PTBD) and endoscopic biliary drainage (EBD). Nevertheless, there has not been a uniform conclusion published on either efficacy of the two types of drainage or the incidence rate of complications. Therefore, we conducted a systematic review and meta-analysis of studies comparing endoscopic versus percutaneous biliary drainage in malignant obstructive jaundice, to determine whether there is any difference between percutaneous and endoscopic biliary drainage, with respect to efficacy and incidence rate of overall complications. Methods The enrolled studies contain a total of three randomized controlled trials and eleven retrospective studies, which together encompass 2246 patients with PTBD and 8100 patients with EBD. Results Our analysis indicates that there is no difference between PTBD and EBD with regard to therapeutic success rate (%), overall complication (%), intraperitoneal bile leak, 30-day mortality, sepsis, or duodenal perforation (%). Cholangitis and pancreatitis after PTBD were lower than after EBD, with odds ratios (OR) of 0.48 (95% confidence interval (CI), 0.31 to 0.74) and 0.16 (95% CI, 0.05 to 0.52), respectively. Incidences of bleeding and tube dislocation for PTBD were higher than EBD, OR of 1.81 (95% CI, 1.35 to 2.44) and 3.41 (95% CI, 1.10 to 10.60). Conclusions This meta-analysis indicates certain advantages for both PTBD and EBD. In the clinical practice, it is advised to choose specifically either PTBD or EBD, based on location of obstruction, purpose of drainage (as a preoperative procedure or a palliative treatment) and level of experience in biliary drainage at individual treatment centers. |
| first_indexed | 2024-12-22T21:59:42Z |
| format | Article |
| id | doaj.art-5874df78ddc34cfe8fb6d93285e835aa |
| institution | Directory Open Access Journal |
| issn | 1470-7330 |
| language | English |
| last_indexed | 2024-12-22T21:59:42Z |
| publishDate | 2017-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Cancer Imaging |
| spelling | doaj.art-5874df78ddc34cfe8fb6d93285e835aa2022-12-21T18:11:08ZengBMCCancer Imaging1470-73302017-10-011711710.1186/s40644-017-0129-1Comparison of efficacy and complications of endoscopic and percutaneous biliary drainage in malignant obstructive jaundice: a systematic review and meta-analysisFeng Duan0Li Cui1Yanhua Bai2Xiaohui Li3Jieyu Yan4Xuan Liu5Department of Interventional Radiology, the General Hospital of Chinese People’s Liberation ArmyDepartment of Interventional Radiology, the General Hospital of Chinese People’s Liberation ArmyDepartment of Interventional Radiology, the General Hospital of Chinese People’s Liberation ArmyDepartment of Interventional Radiology, the General Hospital of Chinese People’s Liberation ArmyDepartment of Interventional Radiology, the General Hospital of Chinese People’s Liberation ArmyDepartment of Interventional Radiology, the General Hospital of Chinese People’s Liberation ArmyAbstract Background Malignant obstructive jaundice is a common problem in the clinic. Currently, the generally applied treatment methods are percutaneous transhepatic biliary drainage (PTBD) and endoscopic biliary drainage (EBD). Nevertheless, there has not been a uniform conclusion published on either efficacy of the two types of drainage or the incidence rate of complications. Therefore, we conducted a systematic review and meta-analysis of studies comparing endoscopic versus percutaneous biliary drainage in malignant obstructive jaundice, to determine whether there is any difference between percutaneous and endoscopic biliary drainage, with respect to efficacy and incidence rate of overall complications. Methods The enrolled studies contain a total of three randomized controlled trials and eleven retrospective studies, which together encompass 2246 patients with PTBD and 8100 patients with EBD. Results Our analysis indicates that there is no difference between PTBD and EBD with regard to therapeutic success rate (%), overall complication (%), intraperitoneal bile leak, 30-day mortality, sepsis, or duodenal perforation (%). Cholangitis and pancreatitis after PTBD were lower than after EBD, with odds ratios (OR) of 0.48 (95% confidence interval (CI), 0.31 to 0.74) and 0.16 (95% CI, 0.05 to 0.52), respectively. Incidences of bleeding and tube dislocation for PTBD were higher than EBD, OR of 1.81 (95% CI, 1.35 to 2.44) and 3.41 (95% CI, 1.10 to 10.60). Conclusions This meta-analysis indicates certain advantages for both PTBD and EBD. In the clinical practice, it is advised to choose specifically either PTBD or EBD, based on location of obstruction, purpose of drainage (as a preoperative procedure or a palliative treatment) and level of experience in biliary drainage at individual treatment centers.http://link.springer.com/article/10.1186/s40644-017-0129-1Endoscopic biliary drainagePercutaneous biliary drainageMalignant obstructive jaundice |
| spellingShingle | Feng Duan Li Cui Yanhua Bai Xiaohui Li Jieyu Yan Xuan Liu Comparison of efficacy and complications of endoscopic and percutaneous biliary drainage in malignant obstructive jaundice: a systematic review and meta-analysis Cancer Imaging Endoscopic biliary drainage Percutaneous biliary drainage Malignant obstructive jaundice |
| title | Comparison of efficacy and complications of endoscopic and percutaneous biliary drainage in malignant obstructive jaundice: a systematic review and meta-analysis |
| title_full | Comparison of efficacy and complications of endoscopic and percutaneous biliary drainage in malignant obstructive jaundice: a systematic review and meta-analysis |
| title_fullStr | Comparison of efficacy and complications of endoscopic and percutaneous biliary drainage in malignant obstructive jaundice: a systematic review and meta-analysis |
| title_full_unstemmed | Comparison of efficacy and complications of endoscopic and percutaneous biliary drainage in malignant obstructive jaundice: a systematic review and meta-analysis |
| title_short | Comparison of efficacy and complications of endoscopic and percutaneous biliary drainage in malignant obstructive jaundice: a systematic review and meta-analysis |
| title_sort | comparison of efficacy and complications of endoscopic and percutaneous biliary drainage in malignant obstructive jaundice a systematic review and meta analysis |
| topic | Endoscopic biliary drainage Percutaneous biliary drainage Malignant obstructive jaundice |
| url | http://link.springer.com/article/10.1186/s40644-017-0129-1 |
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